Managed Care Coordinator – Referrals, Gastroenterology

Beth Israel Lahey Health

. Initiate and process managed care insurance referral requests for practice patients .

Posted 10/27/2026full-timePlymouth • Massachusetts • United StatesJunior💰 $23 - $30 per hourWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates proficiency in managing care insurance referral processes while maintaining patient-centered care and effective communication with patients and healthcare professionals. Skilled in utilizing electronic technologies and web-based applications to streamline referral management and ensure compliance with authorization rules.

Highest-signal resume keywords

Managed Care Referral ProcessingElectronic Technologies ProficiencyCustomer Service OrientationReferral Management TrainingMedical Admin Assistant Certificate

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Referral AuthorizationPatient Care CoordinationWeb-Based ApplicationsMicrosoft Office SuitePOS Point of Service Device

Soft Skills

Effective CommunicationActive ListeningProblem SolvingStress ManagementRespectful Interaction

Tools & Technologies

Health Wire NetworkAetna WebMDNEHENHPHC ConnectNavinetNIA

Certifications & Qualifications

Medical Admin Assistant Certificate

Industry Keywords

Patient-Centered CareManaged CareReferral ManagementAuthorization RulesBilling Problem Resolution

About the role

Key responsibilities & impact

Initiate and process managed care insurance referral requests for practice patients
Maintain patient-centered care, timeliness, quality, accuracy and expected turnaround-time targets
Coordinate and process specialty-care managed-care referral authorization requests with PCPs, patients and practice support staff
Use electronic technologies to initiate, issue and administratively sign off on high-volume referrals
Learn and maintain proficiency with POS Point of Service Device, Health Wire Network, Aetna WebMD, NEHEN, HPHC Connect, Navinet, NIA and other web-based technologies
Serve as a daily point of contact and organizational resource for patients, families, specialty practices, physicians and support staff
Communicate authorized level of care, number of visits and diagnostic testing scope to specialists and patients
Communicate with managed-care payers to resolve referral-management issues
Coordinate with Patient Accounts and internal and external customers to resolve patient billing problems
Help provide referral-management training to new hires
Maintain confidentiality of sensitive patient information
Maintain current knowledge of referral and authorization rules and policies for multiple payers and specialties
Refer patients with complex referral needs to insurance-company case management

Requirements

What you’ll need

High School diploma or GED required
1-3 years related work experience required
Experience with computer systems, including web-based applications and some Microsoft Office applications such as Outlook, Word, Excel, PowerPoint or Access
Ability to communicate clearly and effectively in written English
Ability to comprehend and converse in English
Knowledge of standard concepts, practices, procedures and policies
Ability to interact respectfully with employees, professional staff and external contacts
Ability to provide professional, service-oriented customer service and use active listening and problem solving
Ability to remain calm in stressful situations
Must be vaccinated against influenza as a condition of employment
Medical Admin Assistant Certificate preferred

Benefits

Comp & perks

Influenza vaccination required as a condition of employment
Potential additional pay through shift differentials, call pay, premium pay, and overtime pay, as applicable